Management of an Adult With Type 2 Diabetes With Antidiabetic Medications: A Case Scenario

Patient Discussion: Addition of Pioglitazone

You counsel him to take the consumer research review home to share with his family, refer to it from time to time to remind him why he's taking the drugs, and refer to it for descriptions of the adverse effects.

After this discussion, you and your patient determine that the likelihood of attaining an HbA1c of 7% and the attendant lowering of risk of microvascular complications are worth the increased risk of side effects from adding additional drugs. After further discussion that includes consideration of the “tiers” of pharmacy approval through his insurance company, his understanding of the side effects of each agent, and cost, the decision is made to add 15 mg pioglitazone daily to his regime, while continuing metformin at 1000 mg po daily.